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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (4): 661-666. doi: 10.19723/j.issn.1671-167X.2024.04.019

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Clinicopathological characteristics and prognosis of multilocular cystic renal neoplasm of low malignant potential

Le YU,Shaohui DENG,Fan ZHANG,Ye YAN,Jianfei YE,Shudong ZHANG*()   

  1. Department of Urology, Peking University Third Hospital, Beijing 100191, China
  • Received:2024-03-15 Online:2024-08-18 Published:2024-07-23
  • Contact: Shudong ZHANG E-mail:zhangshudong@bjmu.edu.cn
  • Supported by:
    the National Natural Science Foundation of China(82273389)

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Abstract:

Objective: To analyze the clinicopathological characteristics and prognosis of patients with multilocular cystic renal neoplasm of low malignant potential and compare the clinicopathological characteristics of patients with multilocular cystic renal neoplasm of low malignant potential who underwent different surgical methods. Methods: Clinicopathological data and prognosis of patients admitted to Peking University Third Hospital from January 2010 to September 2023 were collected. Patients who underwent radical nephrectomy or nephron-sparing surgery and were pathologically diagnosed with multilocular cystic renal neoplasm of low malignant potential were identified. Based on the surgical methods, the patients were divided into radical nephrectomy group and nephron-sparing surgery group. The clinicopathological characteristics of the two groups were compared. Results: A total of 35 patients were enrolled in this study. The median age at diagnosis was 53.0 (39.0-62.0) years. Among the 35 patients, 23 were males (65.7%) and 12 were females (34.3%). Nine patients underwent radical nephrectomy (25.7%), while 26 patients underwent nephron-sparing surgery (74.3%). The clinical T-stage of 35 patients did not exceed T2a stage. The median operation time was 145.0 min, and the median estimated intraoperative blood loss was 20.0 mL. The median postoperative hospitalization days was 6.0 d. The postoperative pathological results did not indicate renal sinus invasion, sarcomatous change, adrenal invasion or lymph node invasion. Based on the surgical methods, the patients were divided into a radical nephrectomy group and a nephron-sparing surgery group. There was no significant difference in clinicopathological charac-teristics between the two groups. Except for one patient who was lost to the follow-up, all the other patients were followed up for 8-111 months, with a median follow-up time of 70.5 months. Only one patient died from non-cancer-specific reasons, other patients had no tumor metastasis or recurrence. Conclusion: Patients with multilocular cystic renal neoplasm of low malignant potential have a good prognosis. There is no significant difference in clinicopathological characteristics of patients between nephron-sparing surgery group and radical nephrectomy group for multilocular cystic renal neoplasm of low malignant potential.

Key words: Renal neoplasm, Nephron-sparing surgery, Prognosis

CLC Number: 

  • R737.1

Figure 1

Inclusion and exclusion criteria and the final number of patients in the study MCRNLMP, multilocular cystic renal neoplasm of low malignant potential."

Table 1

Clinicopathological characteristics of MCRNLMP patients"

Items MCRNLMP (n=35)
Age/years, M (P25, P75) 53.0 (39.0, 62.0)
Gender, n (%)
  Male 23 (65.7)
  Female 12 (34.3)
BMI/(kg/m2), M (P25, P75) 24.5 (22.6, 27.7)
Hypertension, n (%) 14 (40.0)
Diabetes, n (%) 6 (17.1)
History of operation, n (%) 15 (42.9)
Laterality, n (%)
  Left 19 (54.3)
  Right 16 (45.7)
Tumor diameter/ cm, M (P25, P75) 4.6 (3.7, 7.0)
Clinical T stage, n (%)
  T1a 14 (40.0)
  T1b 14 (40.0)
  T2a 7 (20.0)
Surgical method, n (%)
  RN 9 (25.7)
  NS 26 (74.3)
Preoperative HGB/(g/L), M (P25, P75) 148.0 (131.0, 154.0)
Preoperative Plt /(g/L), M (P25, P75) 206.0 (172.0, 293.0)
Preoperative WBC count /(×109), M (P25, P75) 5.6 (5.2, 6.6)
Preoperative ALB /(g/L), M (P25, P75) 44.4 (41.5, 46.4)
Preoperative SCr / (μmol/L), M (P25, P75) 80.0 (68.0, 87.0)
Preoperative eGFR/ [mL/(min·1.73 m2)], M (P25, P75) 94.3 (74.1, 118.3)
Operation time/min, M (P25, P75) 145.0 (123.0, 217.0)
Estimated blood loss/mL, M (P25, P75) 20.0 (10.0, 50.0)
Postoperative SCr / (μmol/L), M (P25, P75) 90.0 (80.0, 109.0)
Postoperative eGFR/ [mL/(min·1.73 m2)], M (P25, P75) 82.3 (61.6, 109.5)
Postoperative hospitalization / d, M (P25, P75) 6.0 (5.0, 8.0)
Pathology, n (%)
  Sarcomatous change 0 (0)
  Lymph node invasion 0 (0)
  Adrenal gland invasion 0 (0)
  Renal sinus invasion 0 (0)
Postoperative complications, n (%) 9 (25.7)
Serious complications, n (%) 1 (2.9)

Table 2

Comparison of two groups of MCRNLMP patients"

Items NS (n=26) RN (n=9) P value
Age/years, M (P25, P75) 53.0 (34.5, 64.3) 51.5 (42.0, 55.5) 0.52
Gender, n (%) 0.64
  Male 17 (65.4) 6 (66.7)
  Female 9 (34.6) 3 (33.3)
BMI/(kg/m2), M (P25, P75) 24.3 (22.5, 27.4) 24.2 (21.5, 25.8) 0.84
Hypertension, n (%) 8 (30.7) 6 (66.7) 0.11
Diabetes, n (%) 4 (15.4) 2 (22.2) 0.64
History of operation, n (%) 9 (34.6) 6 (66.7) 0.13
Laterality, n (%) 0.99
  Left 14 (53.8) 5 (55.6)
  Right 12 (46.2) 4 (44.4)
Tumor diameter/ cm, M (P25, P75) 4.3 (3.7, 7.3) 5.3 (3.2, 6.7) 0.22
Clinical T stage, n (%) 0.22
  T1a 12 (46.2) 2 (22.2)
  T1b 8 (30.8) 6 (66.7)
  T2a 6 (23.1) 1 (11.1)
Preoperative HGB/(g/L), M (P25, P75) 147.5 (132.5, 154.8) 140.5 (124.3, 153.3) 0.29
Preoperative Plt/(g/L), M (P25, P75) 207.5 (187.0, 295.0) 210.0 (161.5, 314.0) 0.87
Preoperative WBC count/(×109), M (P25, P75) 5.5 (5.0, 6.6) 6.4 (5.3, 6.6) 0.75
Preoperative ALB/(g/L), M (P25, P75) 45.4 (41.9, 46.7) 43.7 (40.9, 45.5) 0.31
Preoperative SCr/(μmol/L), M (P25, P75) 80.0 (68.3, 87.5) 76.5 (64.3, 96.5) 0.93
Preoperative eGFR/[mL/(min·1.73 m2)], M (P25, P75) 94.2 (79.1, 117.4) 94.3 (54.9, 134.5) 0.78
Operation time/min, M (P25, P75) 134.5 (123.3, 182.5) 212.0 (99.3, 227.8) 0.59
Estimated blood loss/mL, M (P25, P75) 22.5 (10.0, 100.0) 20.0 (15.0, 50.0) 0.57
Postoperative SCr/(μmol/L), M (P25, P75) 82.5 (74.0, 99.3) 115.5 (99.3, 134.8) 0.32
Postoperative eGFR/[mL/(min·1.73 m2)], M (P25, P75) 86.7 (72.8, 109.9) 58.4 (46.2, 84.6) 0.92
Postoperative hospitalization/d, M (P25, P75) 6.0 (5.0, 8.0) 6.0 (4.5, 12.0) 0.57
Postoperative complications, n (%) 7 (26.9) 2 (22.2) 0.99
Serious complications, n (%) 0 (0) 1 (11.1) 0.26
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